The Impact of Patient to Nurse Ratio on Quality of Care and Patient Safety in the Medical and Surgical Wards in Malaysian Private Hospitals: A Cross-sectional Study

Abstract

Background and objective: Nursing shortage and inadequate hospital nursing jeopardized quality of care and patient safety. This study aims to predict the impact of patient to nurse ratio on quality of care and patient safety in medical and surgical wards in Malaysian private hospitals. Methods:Cross-sectional data collected by questionnaire from 652 nurses working in the medical and surgical wards in 12 private hospitals participated in the study. Stratified simple random sampling performed to invite small size (less than 100 beds), medium size (100-199 beds) and large size (over than 200) hospitals' nurse to participate in the study, which allow also nurses from all shift to participate in the study from the participated hospitals.Results: Nurses with higher ratio of patients have greater negative association on quality of care and patient safety. However, this negative association significantly associated with patient safety, whereas insignificantly associated with quality of care. Conclusions:Staffing level inconsistently associated with quality of care and patient safety, so there is at least one intervening process factor mitigate the negative impact of nursing shortage on quality of care in Malaysian hospitals. However, nurses delivering care for 11-15 patients and nurses delivering care for more than 15 patients had significant negative impact on both quality of care and patient safety at a p<0.05 significance level compared with those caring for less than 5 patients.

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